Healthcare organisations around the world face the challenge of digitising their paper records, chasing the benefits of greater efficiency, cost-effectiveness, ease of sharing and environmental-friendliness. In the UK, the NHS is at the forefront of this global effort, with its plans to go entirely paperless by 2020. This approach was laid out in the Department of Health’s report ‘Making IT work’, which stated that, “the one thing that the NHS cannot afford to do is to remain a largely non-digital system. It’s time to get on with IT.”
But the task of adopting a paperless system is a substantial one, and the original 2020 target has already been criticised for being ‘unrealistic’, in an independent review by Robert Wachter which was backed by health secretary Jeremy Hunt. Suggesting 2023 as a more achievable goal, Dr Wachter said that this would be ‘ambitious but achievable’. In a recent debate at e-Health Week meanwhile, Paul Walsh, COO of the HCI Group, said that “some organisations really are struggling,” with the scale of the challenge. So what are the main challenges to a fully digital healthcare system?
Lack of standardisation across individual hospitals and trusts
Each hospital has a multitude of different departments and specialties, with each one collecting different forms of data, and inevitably having different ways of entering and storing that data. In order to prevent electronic health records from becoming a complex and convoluted unusable mess, these many different strands need to be integrated and adapted, and this takes time.
Different sorting/naming systems between NHS organisations
Beyond the level of a single hospital, practice or trust, different organisations within the NHS may use different sorting and naming systems from each other for some data. The problem with this is that if the data is not properly prepared in a standardised way, the attempt to share records between computers would be chaotic and potentially unworkable.
The use of optical character recognition (OCR) technology which can accurately capture and recognise written data in many different forms and configurations can ease this process considerably.
Lack of a single parent IT system
The initial plan for the whole NHS to be linked up in what would have been the world’s largest single civilian computer system was unfortunately abandoned some time ago, years and billions of pounds into the project. This failure demonstrates the difficulty of the tasks involved in a paperless NHS, and the scale of resources required to achieve it. It also highlights the importance of identifying the best solutions at an early stage.
With the NHS under continuing strain due to the need to find ‘efficiency savings’, the question of money is a pertinent one. As these previous mistakes have shown, going digital can be costly, and it’s important to get it right first time.
While some data such as names and addresses may be neatly stored and organised, other patient data such as historical notes may be stored somewhat haphazardly in handwritten paper form. This can make it difficult to sort correctly and organise intuitive into categories and fields. For this you need an accurate and automated way of sorting through and storing through this data.
Using a reliable OCR solution such as Nuance’s OmniPage can help to ensure accuracy first time, by intelligently capturing data, even many years worth of handwritten patient records.
The technical and financial challenges associated with paperless document management are considerable, but so are the human factors which may come into play. Staff who are working many hours and who have done things in very specific ways for their entire careers may be reluctant to get to grips with new ways of doing things, and in some cases may even be hostile towards them. This is another reason that it’s important to get the technology right, to give them something to believe in.
On this final point, intelligent data capture solutions that can accurately capture both digital and hand-written data are key to ensuring consistency throughout a digital document management system, and this is an area where Nuance’s OmniPage can help.